| NPI | 1912095761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4378) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM PSY-RXC0068) |
| 103TC0700X Psychologist, Clinical (Licence: MA 10871) | |
| 103TC0700X Psychologist, Clinical (Licence: NM 1527) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2019-01-07 |